NAP5 and consent

Despite extensive traditional and social media coverage of the NAP5 project on accidental awareness under general anaesthesia (AAGA), I am yet to experience any curiosity from, or increased questioning by, patients about AAGA. The vast majority of my colleagues whom I have questioned have not received any increased questioning about AAGA, and none was intending to inform patients about AAGA in the light of NAP5, excepting the fifth of those who would now inform obstetric patients about the risk. I wonder then, how much of a need NAP5 has created for changing the current consent process or altering practice 1? Additional comments from colleagues indicated concerns about anaesthetists in future using opioids during rapid sequence induction, limiting the use of neuromuscular blocking drugs, foregoing total intravenous anaesthesia and abandoning depth of anaesthesia monitoring, in order to avoid AAGA, at the expense of patient safety. Although national audit projects provide fundamental objective data and sensible guidelines, I am concerned that these do not necessarily equate with improvements – or indeed, any change – in practice. I would like to suggest that future projects concentrate specifically on how simple messages can be best disseminated both to the public and to clinicians.